Challenges for model-based economic evaluations of postmenopausal osteoporosis interventions

Area of Science:

• Health economics
• Biostatistics
• Pharmacoeconomics

Background:

• Assessing long-term osteoporosis treatment cost-effectiveness relies on mathematical models due to scarce long-term clinical trial data.
• Randomized clinical trials often lack comparisons of all relevant interventions for osteoporosis.

Purpose of the Study:

• To report on specific modeling challenges encountered during the development of a natural history model for postmenopausal osteoporosis.
• To create a model suitable for assessing the cost-effectiveness of osteoporosis interventions across diverse populations and countries.

Main Methods:

• Development of a mathematical model for postmenopausal osteoporosis natural history.
• Addressing challenges including choice of modeling bone mineral density (BMD) or fracture rate, defining health states, modeling mortality and long-term care costs post-fracture, incorporating health utility, and model validation.

Main Results:

• Identification of critical modeling challenges in postmenopausal osteoporosis economic evaluations.
• Development of a framework to guide future model creation and decision-making.

Conclusions:

• This work facilitates future postmenopausal osteoporosis model development.
• Provides insights for decision-makers evaluating model-based economic analyses of osteoporosis interventions.